title: [Laparoscopic repair of pelvic organ prolapse by lateral suspension with mesh: a continuous series of 218 patients].
abstract: OBJECTIVE
  To evaluate the technique of laparoscopic lateral colpo-uterine suspension using a mesh to treat pelvic organ prolapse, with a sufficient follow-up.
  
  
  METHODS
  The technique consists of two steps. First, the lateral suspension of the vaginal vault and of the uterus is performed using a polypropylene mesh placed in the vesicovaginal septum as a transversal hammock. The second step is the application of a polypropylene patch to the posterior surface of the vagina and the rectovaginal septum. The transversal hammock is placed laterally by the tension-free fixation of the mesh to the lateral abdominal wall above the iliac crests. Between January 2004 and December 2007, 218 patients were treated. It is a continuous series including all the patients needing a surgical procedure to treat a genital prolapse. We excluded, from the study, the patients with a severe cardiorespiratory disease and the cases of isolated rectocele.
  
  
  RESULTS
  We observed a recurrence of the prolapse in thirty patients (13.76%). A reoperation was performed in 10 patients (4.6%). One complication was related to the technique of lateral suspension (bladder injury immediately sutured 0.46%). A mesh erosion was noted in 13 cases (5.96%), nine were treated by vaginal excision of the mesh (4.12%).
  
  
  CONCLUSIONS
  The laparoscopic lateral colpo-uterine suspension using a mesh corrects the pelvic organ prolapse with a predominant cystocele or rectocele. It is an interesting alternative to the other procedures because of the low risk of complications and the satisfactory results.
authors.affiliation: Département de gynécologie et obstétrique, hôpitaux universitaires de Genève, boulevard de la Cluse 30, Geneva, Switzerland.
authors.forename: J-B
authors.initials: JB
authors.lastname: Dubuisson
authors.forename: I
authors.initials: I
authors.lastname: Eperon
authors.forename: S
authors.initials: S
authors.lastname: Jacob
authors.forename: J
authors.initials: J
authors.lastname: Dubuisson
authors.forename: J-M
authors.initials: JM
authors.lastname: Wenger
authors.forename: P
authors.initials: P
authors.lastname: Dallenbach
authors.forename: I
authors.initials: I
authors.lastname: Kaelin-Gambirasio
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D013526:Surgical Mesh; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000601:surgery; D014599:Uterus; D014621:Vagina